Sunday, May 10, 2015

Not so quality medical care, Momma's sick.

I held off on writing this because I don't like to write from emotion alone no matter how I'm feeling. I want to step back and be fair, re-evaluate and think the entire situation through.  Ok, and not be so mad that I'm typing out f-bombs like punctuation, which is a very accurate description of where I was earlier today.

I've always been very supportive of our local clinic and hospital.  We are very fortunate for a small town to have the medical facilities that we do. I've never really understood why people leave town for medical care - especially in an emergency - or complained about the quality of care that is provided.

Until today. 

I am the first to admit, I've been incredibly spoiled with the absolute best medical care for my family.  I was under the care of Dr. Steutermann for both of my babies, because of him and the great medical team that delivered Parker as an emergency c-section my uterus was saved and 3 years later I welcomed my beautiful princess, Allison, into this world.  When Parker's delivery took a turn for the worse (for me, not him) Dr. Steutermann never gave up, I'm told he swore like a sailor that day which was incredibly uncommon for him but his determination persevered and to this day, I am thankful to him.  I received incredible care pre and post pregnancy. To this day, since his passing, I have not replaced him... I know I need to but... I haven't.  From birth, Dr. Krock has been a part of Parker and Allison's lives.  If there is something he is not familiar with, he's open and honest about that with me and searches for an answer.  He's incredible with both of my children, accommodating for their disability, always learning, always asking questions and always putting new solutions out for us.  He works wonderfully with the Fragile X specialists and holds my highest respect. It takes a lot to get me to the doctor, I was under the incredible care of Dr. Day for many years until he retired. Replacing him took me a lot of time (ok, and getting really sick) because those were going to be some huge shoes to fill.  I was lucky to be referred to Dr. Bowers, who has always went above and beyond for me, listens and doesn't give up on me.

Several years ago, Allison had stitches from a mole being removed by her dermatologist near her ear.  The day of her birthday party  she landed wrong on the trampoline (which she had been cleared to jump on) and split the stitches open... at 4:55 pm.  With a quick call to the clinic, Dr. Buckley and his nurses told us to hurry down, they would stay and wait for us and stitch her back up without a trip to the ER.  This is the type of home town, personalized care that we've always had.

It's not just the doctors, we've had the best nurses like Elsie and Mary (and way too many to name), I'm yet to meet a receptionist that I don't adore and last week when I took Parker to the lab for a throat culture, we had - hands down the best lab girl in the entire world.  (her name is in my office as I have on my list to write the clinic singing her praise).  She was outstanding with Parker thoroughly impressing me and successfully getting his throat culture.  To say she was amazing, fun and spot on with working with someone with a disability just isn't praise enough for what I witnessed.

So, yeah... spoiled.  I've been spoiled with incredible medical care here.  Spoiled to the point that I expect it.  I expect to have qualified, pleasant, caring professionals working with me on my medical needs.  Not getting that today has left me understanding why people don't choose our local clinic and services.  

Here's why.

My allergies have been difficult all week.  Pollen counts are high, everyone is mowing, my windows were open for 2 days because our air went out.  Our allergies are the reason you rarely ever find our windows open (and reason #18471 I love winter so much).  So as the week has went on and I've become increasingly more ill, I began to question if it was really just my allergies.  I was faithfully taking Mucinex, Tylenol, Ibuprofen, Clariton and now and then Robitussin just for an attempt to breathe.  As the week went on, I developed a tight, deep cough and wheezing. I couldn't take a deep breath and my chest felt like a million pounds of pressure caving in.  My ears began to ache, my throat began to swell, I couldn't regulate my body temp and I could not shake the headache and pressure in my head.  Still... I had this under control.

Until I woke up this morning with a 103 degree fever and chills in addition to everything above.  I was a barely functioning mess.  It was also Parker's regional track meet, not just his opportunity to qualify for state but also he was chosen as one of the members of his team to be part of the torch run during opening ceremonies.  This is an opportunity that will likely never come along again.  Missing it was not an option.

My mom met us in Monmouth for the track meet.  Mom, I should mention, is a nurse.  In talking with her and with Scott's girl friend, Jen - also a nurse, it was clear I would need to leave the track meet and get into Urgent Care for something fast acting in the form of a shot, to get me started.

I left the track meet after 2 of Parker's 3 events and headed back to Canton after debating going to the Galesburg Urgent care because it was closer.  I chose to drive all the way back because this is where my trust is.

I thought it would be better to call Urgent care instead of just walking in, giving both them and me a better idea of who would be there and the approximate wait time.  When I called, the receptionist said their appointments were full but she would pass me back to the nurse who could help me.  That conversation was the start of what was a day of understanding all of the negative attention our clinic gets.

While on hold, the phone suddenly started to ring.  When someone answered I was not sure if I was back with the receptionist or what had happened, so I said, "Hi, I was holding for the nurse." in response to the "Hello?" at the other end.

She replied, "This is the nurse."
I said, "I understand you are full this afternoon but I need to get in to be seen.  I was wondering if it is possible to make an appointment."
She said, "No.  We are full."
I said, "Ok, well, you are a walk in clinic, correct?  I can just walk in to be seen."
She said, "No.  You have (counting) 14 people in front of you.  It'll be at least 2 hours."
I said, "Ok, then can you put me down for 2:46 ( 2 hours from the current time)"
She said, "No. We are not taking appointments."
I said, "Ok, I can come in as a walk in and wait 2 hours."
She said, "No."

MIND YOU, she never even asked what was wrong.  My voice was incredibly horse, I was struggling to breathe to talk - clearly I was sick.

I said, "Actually I can."
She said, "If you wanted to be seen you needed to come in or call at 8:30 when we opened."
I said, "8:30 this morning was not an option. I had other obligations."
She said, "If you were able to do other obligations you are clearly not that sick."
I said, "You have no idea how sick I am. This was not an option. I will just walk in and wait."
She said: "If you are that sick, you should go to the ER."
I said, "There is not point to go to the ER when we have an Urgent care. That is why you are there. I will just walk in."
She said (again) "We do not have time, there are 14 people ahead of you."
I said, "I look forward to spending time with you in a couple hours. I can't wait." and hung up on her.... possibly after muttering something resembling the f-bomb.  Not my best moment.

When I arrived at the clinic there was ONE, yes 1 car in the parking lot.  I took pictures I was taken off guard by the lack of cars there.  No one was in the waiting room. It was just a super sweet receptionist.

I told her I'd like to make an appointment, hearing my voice she said, "didn't you call a little bit ago?"  I said, "Yes and against the nurses advice, I am here."  She said, "You are in luck, we had a 1:45 appointment just cancel.  I can put you in that time slot."  I said that would work.  She apologized for the lengthy wait time which I told her I understood and expected at an Urgent Care, especially without an appointment and thanked her for getting me in.  A couple of people (3, I believe) came in with appointments while I waited.  No big deal.  Clearly not 14 but I was rather thankful for that miscalculation given how bad I was feeling.

When I went back my temp was 101 with Tylenol 2 hours in my system. When I was seen the focus was on my allergies.  I was simply having an allergy attack.  No looking into my ears, my throat, nothing.  Just a strong recommendation to use a netti bottle (which I am very opposed to knowing that if your water is not clean enough you could be doing more harm than good and I was raised not to stick things in my nose - yes, I know many people love them - please, this is not about netti cleanses, that is just my personal 2 cents - it's personally not for me.) I mentioned that my daughter had strep a couple of weeks ago and it was said "maybe that was what was going on with me."  Moving the exam on, it was discovered I was wheezing and had significant chest congestion, I also have fluid in my ears - the left ear being really bad and my throat is red and sore.  No clue on the strep as no culture was ordered.

I said that although I haven't used my inhaler in a couple of years, I do have asthma.  I was told, I don't. I likely grew out of it.  Interesting that 2 years ago, I still had it.  Apparently 41 is that magical age where it disappears.  I wish someone would inform my lungs of that.

The decision was made that I was in crappy shape. 3 shots would be ordered to accelerate the healing process. (I liked this a lot, especially since it was what my mom wanted), an inhaler would be ordered to open up my lungs and an antibiotic to start that evening.

I will say, everyone was very nice.  Nothing at all like the phone call.  They all urged me to call or come in the next day if there was any troubles or I was not better.  Perfect. I was willing to write off the crappy and unprofessional phone call.  I asked about my prescriptions and was told they had already been faxed to Walgreens and I could go pick them up.  So I left, empty handed, no idea what I was shot up with or if this burning in my hips from the 3 shots would subside anytime soon.

I went to Walgreens to pick up my prescription and they said they had not received it yet so I went home to lay down.  I was completely exhausted, burning up with a fever and in really bad pain from the shots.  So, I called mom.  She told me to ice the spots and take a nap, however because I didn't have any paperwork I couldn't tell her what the shots were which made it difficult for her to tell me how long the pain may last.

I woke up after a short nap and went back to Walgreens only to find out they still did not have anything.  They checked their Walgreens system and there was nothing for any of their stores. They recommended I call WalMart to see if it went to the wrong place, so I did.  Nothing.

Here we were, almost 6 pm. Urgent care is closed and our pharmacy's are about to close for the night.  I have had 3 shots and need my inhaler and antibiotic so I call the hospital.  The incredibly sweet receptionist (really, this part of the job they have down!) who paged the dr on call to see if he could access my records and help.

I had already looked at the online patient portal which was incomplete.  Part of my information was there from today part was not.  Lots of "directions are in the notes section" (or something to that effect) was written but nothing in my notes or email, just a partially complete review of the day.  When the doctor called I told him what was going on, he asked what was prescribed and I said I believe Bactrim but I did not know on the inhaler nor did I know the dosage.

He asked which pharmacy and I said my only option is to go to Pekin, 40 minutes away and could he verify that the pharmacy would be open long enough for me to make the drive before giving them the order.  He said, "No. That is the responsibility of the patient. You need to know the hours of the pharmacy of your choice."  Well, I was tearfully sitting with a fever barely able to breathe in the parking lot of the pharmacy of my choice and they were closing. I am sorry I do not know the hours of pharmacy's I never use.  So I said I would look that information up and call him back.  I did.  4 times and he never answered.

So, I called the hospital back and asked them to page him again and request that he call me.  He did.  I told him the pharmacy I wanted, thanked him and started the drive over.  On the way over I called to be sure that my script was called in, it turns out the pharmacy I thought was open til 10 was closed.  Apparently I do not do my best research when I am sick as I looked at their weekday hours, not the weekend ones.  There is another location in Pekin with a 24 hour pharmacy so I called the hospital back, explained my mistake and asked them to page the dr to have him use this other pharmacy.  He did.

When I arrived they had the antibiotic but no inhaler was called in.  I understand that the dr on call for the hospital didn't see me and couldn't prescribe an inhaler without treating me or being able to find it in the notes left by the doctor who had treated me earlier.  I was happy and feeling victorious for having 1 of the 2 items.

Here's the thing.  I understand busy.  Trust me, I understand busy.  I understand frustration. I understand wanting your day to be done.  I understand bad days.

What I don't understand is rudeness.  I don't understand telling someone who is ill that they were clearly not "that ill" if they couldn't come in as you opened your doors and telling them to go elsewhere and not come in at all.

I don't understand incomplete file updates that are being done electronically while you are with the patient.

I don't understand not listening to the patient.

I don't understand saying you faxed in a prescription when you did not. I don't understand how I was sick enough for 3 shots but not for the additional pills to be called in so I could be properly treated.

It's rare I have to stray away from our regular doctors. I'm thankful we have an Urgent Care but will say that based on first impressions - this could not have went much worse. It was not the level of patient care I expect.  It wasn't even close.  I don't expect to be catered to. I expect to wait my turn, I expect to have to update someone who has never met me with all of the things my regular doctor would know... I'm realistic.  What I don't appreciate it being told not to come in and my medications not being called in for me.  I don't like not having information on what shots I was given, it's hard to gauge reactions and interactions if I have no idea what was put into my body (I'd still go the shot route, it was the best decision, I just want to know WHAT it was.) I don't like making multiple phone calls, driving 40 minutes each way and only having part of my medications.

Maybe I'm picky.  Maybe I'm spoiled. Maybe it's a reflection of how crappy I feel.  But this to me is not quality care.  This is not what I expect and I am sad to now understand why others are so quick to go elsewhere and complain so often about the services provided.

I'm also thankful that come Monday, I can call my regular doctor ... who I know will provide quality care.

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